The Effects of SARS-CoV-2 Infection on Female Fertility: A Review of the Literature.

As the coronavirus pandemic is far from ending, more questions regarding the female reproductive system, particularly fertility issues, arise. The purpose of this paper is to bring light upon the possible link between COVID-19 and women's reproductive health. This review emphasizes the effect of SARS-CoV-2 on the hormones, endometrium and menstrual cycle, ovarian reserve, follicular fluid, oocytes, and embryos. The results showed that endometrial samples did not express SARS-CoV-2 RNA. Regarding the menstrual cycle, there is a large range of alterations, but they were all reversible within the following months. The ovarian reserve was not significantly affected in patients recovering from both mild and severe infection in most cases, except one, where the levels of AMH were significantly lower and basal follicle-stimulating hormone (FSH) levels were increased. All COVID-19 recovered patients had positive levels of SARS-CoV-2 IgG in the follicular fluid. The amount of retrieved and mature oocytes and the fertilization rate were unharmed in three studies, except for one study, where the quantity of retrieved and mature oocytes was reduced in patients with higher levels of SARS-CoV-2 antibodies. The numbers of blastocysts, top-quality embryos, and euploid embryos were affected in most of the studies reviewed.

Experience of the "Prof. Dr. Panait Sarbu" Hospital in Oncofertility among Breast Cancer Patients.

Introduction: Oncofertility represents a new field, dedicated to patients at childbearing age who are diagnosed with a neoplasic disease and who want to have a biologic child after they complete the oncological and surgical treatment. Because of new screening and treatment methods, most patients survive the disease, but the main long-term complication remains infertility. Young women with breast cancer are candidates for preserving their fertility mostly because of the risk of chemotherapy-related infertility due to the alkylating agent, causing dose-dependent destruction of oocytes and follicular depletion and thus bringing cortical fibrosis and ovarian blood-vessel damage (1). "Prof. Dr. Panait S #226;rbu" hospital is the first medical facility in Romania which performs oncofertility procedures among breast cancer patients within the program "Newborn Oncofertility". Material and Methods: Within the program run by our hospital 21 patients (13 men and 8 women) came for fertility preservation, including 5 patients diagnosed with breast cancer. Our specialists in reproductive medicine performed ovarian stimulation and oocyte pick-up, after which the genetic material was cryopreserved. The procedure could be performed only if the patients were under 35 years old, and provided the case had been previously discussed within the tumor board and the patient had received the oncological agreement. Disscution: There was a slight predominance of breast cancer patients who addressed the clinic with a view for preserving their fertility and those who met the conditions could start the procedure immediately, without any delay when it comes to oncological or surgical treatments. There were no side effects during ovarian stimulation treatment. Oocytes or embryos were cryopreserved using the method of vitrification.